NPI | 1164414207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002584B) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002584A) |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IN 18002584B) | |
Enumeration Date | 2005-08-16 |
Last Update Date | 2024-02-06 |